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ATI Pharmacology Proctored 2025 latest version consis, Exams of Nursing

ATI Pharmacology Proctored 2025 latest version consis

Typology: Exams

2024/2025

Uploaded on 06/06/2025

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ATI Pharmacology Proctored
2025 latest version consist of
all variety on drugs on health
2025/2026.
, Patient identifiers - CORRECT ANSWERS--Medical record number
-home telephone number
What lab values should a nurse monitor for a patient with chronic renal failure? -
CORRECT ANSWERS-■ Urinalysis
Hematuria, proteinuria, and alterations in specific gravity
Serum creatinine
- Gradual increase of 1 to 2 mg/dL per every 24 to 48 hr for acute renal
failure (ARF)
- Gradual increase over months to years for chronic renal failure (CRF)
exceeding 4 mg/dL
■ Blood urea nitrogen (BUN)
- 80 to 100 mg/dL within 1 week with ARF
- Gradual increase with elevated serum creatinine over months to years for
CRF
- 180-200 mg/dL with (CRF)
■ Serum electrolytes
- Decreased sodium (dilutional) and calcium, increased potassium,
phosphorus, and magnesium
■ Complete blood count (CBC)
- Decreased hemoglobin
What food should you increase when taking Lasix? - CORRECT ANSWERS--increased
amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice)
Patient reports IV discomfort, what is your first action? - CORRECT ANSWERS-color
and temperature
Sumatriptan (treats migraine headaches) adverse effect - CORRECT ANSWERS-pain,
tightness, pressure, or heaviness in the chest, throat, neck, and/or jaw
slow or difficult speech
Know about Transdermal patch - CORRECT ANSWERS--• Apply at the same time once
each day,
preferably in the morning. Keep patch on
for 12 to 14 hr each day.
• Remove the patch at night to reduce
the risk of developing tolerance to
nitroglycerin. Be medication-free a
minimum of 10 to 12 hr each day (usually
at night).
• Do not cut patches to ensure appropriate
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Download ATI Pharmacology Proctored 2025 latest version consis and more Exams Nursing in PDF only on Docsity!

ATI Pharmacology Proctored

2025 latest version consist of

all variety on drugs on health

, Patient identifiers - CORRECT ANSWERS--Medical record number -home telephone number What lab values should a nurse monitor for a patient with chronic renal failure? - CORRECT ANSWERS-■ Urinalysis ☐ Hematuria, proteinuria, and alterations in specific gravity ☐ Serum creatinine

  • Gradual increase of 1 to 2 mg/dL per every 24 to 48 hr for acute renal failure (ARF)
  • Gradual increase over months to years for chronic renal failure (CRF) exceeding 4 mg/dL ■ Blood urea nitrogen (BUN)
  • 80 to 100 mg/dL within 1 week with ARF
  • Gradual increase with elevated serum creatinine over months to years for CRF
  • 180-200 mg/dL with (CRF) ■ Serum electrolytes
  • Decreased sodium (dilutional) and calcium, increased potassium, phosphorus, and magnesium ■ Complete blood count (CBC)
  • Decreased hemoglobin What food should you increase when taking Lasix? - CORRECT ANSWERS--increased amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) Patient reports IV discomfort, what is your first action? - CORRECT ANSWERS-color and temperature Sumatriptan (treats migraine headaches) adverse effect - CORRECT ANSWERS-pain, tightness, pressure, or heaviness in the chest, throat, neck, and/or jaw slow or difficult speech Know about Transdermal patch - CORRECT ANSWERS--• Apply at the same time once each day, preferably in the morning. Keep patch on for 12 to 14 hr each day.
  • Remove the patch at night to reduce the risk of developing tolerance to nitroglycerin. Be medication-free a minimum of 10 to 12 hr each day (usually at night).
  • Do not cut patches to ensure appropriate

dosage.

  • Place the patch on a hairless area of skin (chest, back, or abdomen) and rotate sites to prevent skin irritation.
  • Wash skin with soap and water and dry thoroughly before applying new patch. RBC Blood transfusion - CORRECT ANSWERS-http://www.atitesting.com/ati_next_gen/FocusedReview/data/datacontext/ RM%20AMS%20RN%208.0%20Chp%2044.pdf (prime with normal saline and infuse with sodium chloride). What to understand about Parkinson's Meds? - CORRECT ANSWERS--they don't cure disease, they slow the process. NEUPOGEN (filgrastim)-what is the appropriate route of this med? - CORRECT ANSWERS-administered by subcutaneous injection or IV infusion Lisinopril therapeutic effect - CORRECT ANSWERS-blood pressure answer (e.g. 120/80) Medication for Schizophrenia - CORRECT ANSWERS-risperidone, Risperdal Macrodantin medication - CORRECT ANSWERS-used to treat or prevent certain urinary tract infections Haldol-inform if you are taking ____________ medication. - CORRECT ANSWERS-- benzodiazepine class of anti-anxiety drugs (all ending with "pam") and even, Xanax. Fosomax - CORRECT ANSWERS-same as-Alendronate is used for treating osteoporosis in men and postmenopausal women. Lipitor - CORRECT ANSWERS--lowers cholesterol in blood, "statins". Reduce LDL and total cholesterol. Raise HDL. Garamycin- - CORRECT ANSWERS-Antibiotic that is toxic to the kidney, injected for radiology studies. Digoxin side effects - CORRECT ANSWERS--Fatigue -Bradycardia -Anorexia -Nausea/Vomiting Singulair - CORRECT ANSWERS-used before exercise to prevent breathing problems during exercise (bronchospasm). What medication to administer with Tylenol overdose? - CORRECT ANSWERS- acetylcysteine (Mucomyst) must be given IV HPV vaccine - CORRECT ANSWERS-Human Papilloma Virus (HPV2, HPV4) - -Three doses should be given over a 6 month -interval for females at 11 to 12 years of age (minimum age is 9 years). -The second dose should be administered 2 months after the first dose, and the third dose should be administered 6 months after the first dose. -HPV4 may be given to males starting at age 9 years of age. Opioid toxicity-what to check first - CORRECT ANSWERS-oxygen saturation Valporic Acid lab - CORRECT ANSWERS-liver Lithium report immediately - CORRECT ANSWERS-slurred speech Prednisone report - CORRECT ANSWERS-sore throat Food to avoid when taking Lithium - CORRECT ANSWERS--salty foods
  1. Immediately before exposure to the sun
  2. At least 30 minutes before exposure to the sun - CORRECT ANSWERS-4. At least 30 minutes before exposure to the sun Rationale: Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating. 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action?
  3. Notifying the registered nurse
  4. Discontinuing the medication
  5. Informing the client that this is normal
  6. Applying a thinner film than prescribed to the burn site - CORRECT ANSWERS-3. Informing the client that this is normal Rationale: Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat burns to reduce bacteria present in avascular tissues. The client should be informed that the medication will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect 6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred? 1.Hyperventilation 2.Elevated blood pressure 3.Local pain at the burn site 4.Local rash at the burn site - CORRECT ANSWERS-1.Hyperventilation Rationale: Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be expected from the pain that occurs with a burn injury. 7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed?
  7. Platelet count
  8. Triglyceride level
  9. Complete blood count
  10. White blood cell count - CORRECT ANSWERS-2. Triglyceride level Rationale: Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before treatment and periodically thereafter until the effect on the triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored specifically during this treatment.

8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication?

  1. Vitamin A
  2. Digoxin (Lanoxin)
  3. Furosemide (Lasix)
  4. Phenytoin (Dilantin) - CORRECT ANSWERS-1. Vitamin A Rationale: Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin. 9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which of the following body areas?
  5. Back
  6. Axilla
  7. Soles of the feet
  8. Palms of the hands - CORRECT ANSWERS-2. Axilla Rationale: Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions in which permeability is poor (back, palms, soles). 10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:
  9. Acne
  10. Eczema
  11. Hair loss
  12. Herpes simplex - CORRECT ANSWERS-1. Acne Rationale: Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect. 11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatments?
  13. "The medication is an antibacterial."
  14. "The medication will help heal the burn."
  15. "The medication will permanently stain my skin."
  16. "The medication should be applied directly to the wound." - CORRECT ANSWERS-
  17. "The medication will permanently stain my skin." Rationale:

15.) The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?

  1. Alopecia
  2. Chest pain
  3. Pulmonary fibrosis
  4. Orthostatic hypotension - CORRECT ANSWERS-4. Orthostatic hypotension Rationale: A side effect specific to etoposide is orthostatic hypotension. The client's blood pressure is monitored during the infusion. Hair loss occurs with nearly all the antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this medication. 16.) The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client:
  5. To take aspirin (acetylsalicylic acid) as needed for headache
  6. Drink beverages containing alcohol in moderate amounts each evening
  7. Consult with health care providers (HCPs) before receiving immunizations
  8. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair - CORRECT ANSWERS-3. Consult with health care providers (HCPs) before receiving immunizations Rationale: Because antineoplastic medications lower the resistance of the body, clients must be informed not to receive immunizations without a HCP's approval. Clients also need to avoid contact with individuals who have recently received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side effects. 17.) The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?
  9. Diarrhea
  10. Hair loss
  11. Chest pain
  12. Numbness and tingling in the fingers and toes - CORRECT ANSWERS-4. Numbness and tingling in the fingers and toes Rationale: A side effect specific to vincristine is peripheral neuropathy, which occurs in almost every client. Peripheral neuropathy can be manifested as numbness and tingling in the fingers and toes. Depression of the Achilles tendon reflex may be the first clinical sign indicating peripheral neuropathy. Constipation rather than diarrhea is most likely to occur with this medication, although diarrhea may occur occasionally. Hair loss occurs with nearly all the antineoplastic medications. Chest pain is unrelated to this medication. 18.) The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?
  13. Pancreatitis
  14. Diabetes mellitus
  1. Myocardial infarction
  2. Chronic obstructive pulmonary disease - CORRECT ANSWERS-1. Pancreatitis Rationale: Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or if the client has a history of pancreatitis. The medication impairs pancreatic function and pancreatic function tests should be performed before therapy begins and when a week or more has elapsed between administration of the doses. The client needs to be monitored for signs of pancreatitis, which include nausea, vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not contraindicated with this medication. 19.) Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to:
  3. Increase DNA and RNA synthesis.
  4. Promote the biosynthesis of nucleic acids.
  5. Increase estrogen concentration and estrogen response.
  6. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors. - CORRECT ANSWERS-4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Rationale: Tamoxifen is an antineoplastic medication that competes with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Tamoxifen is used to treat metastatic breast carcinoma in women and men. Tamoxifen is also effective in delaying the recurrence of cancer following mastectomy. Tamoxifen reduces DNA synthesis and estrogen response. 20.) The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
  7. Glucose level
  8. Calcium level
  9. Potassium level
  10. Prothrombin time - CORRECT ANSWERS-2. Calcium level Rationale: Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels, along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain. 21.) A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply.
  11. Tinnitus
  12. Ototoxicity
  13. Hyperkalemia
  14. Hypercalcemia
  15. Nephrotoxicity
  16. Hypomagnesemia - CORRECT ANSWERS-1. Tinnitus
  1. Injects an amount of air equal to the desired dose of insulin into the vial - CORRECT ANSWERS-1. Withdraws the NPH insulin first Rationale: When preparing a mixture of regular insulin with another insulin preparation, the regular insulin is drawn into the syringe first. This sequence will avoid contaminating the vial of regular insulin with insulin of another type. Options 2, 3, and 4 identify the correct actions for preparing NPH and regular insulin. 25.) A home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse tells the client to:
  2. Freeze the insulin.
  3. Refrigerate the insulin.
  4. Store the insulin in a dark, dry place.
  5. Keep the insulin at room temperature. - CORRECT ANSWERS-2. Refrigerate the insulin. Rationale: Insulin in unopened vials should be stored under refrigeration until needed. Vials should not be frozen. When stored unopened under refrigeration, insulin can be used up to the expiration date on the vial. Options 1, 3, and 4 are incorrect. 26.) Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A nurse reinforces instructions for the client and tells the client to avoid which of the following while taking this medication?
  6. Alcohol
  7. Organ meats
  8. Whole-grain cereals
  9. Carbonated beverages - CORRECT ANSWERS-1. Alcohol Rationale: When alcohol is combined with glimepiride (Amaryl), a disulfiram-like reaction may occur. This syndrome includes flushing, palpitations, and nausea. Alcohol can also potentiate the hypoglycemic effects of the medication. Clients need to be instructed to avoid alcohol consumption while taking this medication. The items in options 2, 3, and 4 do not need to be avoided. 27.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?
  10. Neuralgia
  11. Insomnia
  12. Use of nitroglycerin
  13. Use of multivitamins - CORRECT ANSWERS-3. Use of nitroglycerin Rationale: Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus cavernosum of the penis, thus sustaining an erection. Because of the effect of the medication, it is contraindicated with concurrent use of organic nitrates and nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia and insomnia are side effects of the medication.

28.) The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the appropriate intervention?

  1. The medication is administered within 60 minutes before the morning and evening meal.
  2. The medication is withheld and the HCP is called to question the prescription for the client.
  3. The client is monitored for gastrointestinal side effects after administration of the medication.
  4. The insulin is withdrawn from the Penlet into an insulin syringe to prepare for administration. - CORRECT ANSWERS-2. The medication is withheld and the HCP is called to question the prescription for the client. Rationale: Exenatide (Byetta) is an incretin mimetic used for type 2 diabetes mellitus only. It is not recommended for clients taking insulin. Hence, the nurse should hold the medication and question the HCP regarding this prescription. Although options 1 and 3 are correct statements about the medication, in this situation the medication should not be administered. The medication is packaged in prefilled pens ready for injection without the need for drawing it up into another syringe. 29.) A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is:
  5. 2 to 4 hours after administration
  6. 4 to 12 hours after administration
  7. 16 to 18 hours after administration
  8. 18 to 24 hours after administration - CORRECT ANSWERS-2. 4 to 12 hours after administration Rationale: Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5 hours, it peaks in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time. 30.) A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
  9. Prednisone
  10. Phenelzine (Nardil)
  11. Atenolol (Tenormin)
  12. Allopurinol (Zyloprim) - CORRECT ANSWERS-1. Prednisone Rationale: Prednisone may decrease the effect of oral hypoglycemics, insulin, diuretics, and potassium supplements. Option 2, a monoamine oxidase inhibitor, and option 3, a β- blocker, have their own intrinsic hypoglycemic activity. Option 4 decreases urinary excretion of sulfonylurea agents, causing increased levels of the oral agents, which can lead to hypoglycemia.
  1. Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes. Rationale: Repaglinide is a rapid-acting oral hypoglycemic agent that stimulates pancreatic insulin secretion that should be taken before meals, and that should be withheld if the client does not eat. Hypoglycemia is a side effect of repaglinide and the client should always be prepared by carrying a simple sugar with her or him at all times. Metformin is an oral hypoglycemic given in combination with repaglinide and works by decreasing hepatic glucose production. A common side effect of metformin is diarrhea. Muscle pain may occur as an adverse effect from metformin but it might signify a more serious condition that warrants health care provider notification, not the use of acetaminophen. 34.) A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment?
  2. Monitoring the leukocyte count for 2 days after the infusion
  3. Checking the frequency and consistency of bowel movements
  4. Checking serum liver enzyme levels before and after the infusion
  5. Carrying out a Hematest on gastric fluids after the infusion is completed - CORRECT ANSWERS-2. Checking the frequency and consistency of bowel movements Rationale: The principal manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab (Remicade) is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication. 35.) The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?
  6. Constipation
  7. Abdominal pain
  8. An episode of diarrhea
  9. Hematest-positive nasogastric tube drainage - CORRECT ANSWERS-3. An episode of diarrhea Rationale: Loperamide is an antidiarrheal agent. It is used to manage acute and also chronic diarrhea in conditions such as inflammatory bowel disease. Loperamide also can be used to reduce the volume of drainage from an ileostomy. It is not used for the conditions in options 1, 2, and 4. 36.) The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client?
  10. Paralytic ileus
  11. Incisional pain
  12. Urinary retention
  13. Nausea and vomiting - CORRECT ANSWERS-4. Nausea and vomiting Rationale: Ondansetron is an antiemetic used to treat postoperative nausea and vomiting, as well as nausea and vomiting associated with chemotherapy. The other options are incorrect.

37.) The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?

  1. Weight loss
  2. Relief of heartburn
  3. Reduction of steatorrhea
  4. Absence of abdominal pain - CORRECT ANSWERS-3. Reduction of steatorrhea Rationale: Pancrelipase (Pancrease MT) is a pancreatic enzyme used in clients with pancreatitis as a digestive aid. The medication should reduce the amount of fatty stools (steatorrhea). Another intended effect could be improved nutritional status. It is not used to treat abdominal pain or heartburn. Its use could result in weight gain but should not result in weight loss if it is aiding in digestion. 38.) An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?
  5. Tremors
  6. Dizziness
  7. Confusion
  8. Hallucinations - CORRECT ANSWERS-3. Confusion Rationale: Cimetidine is a histamine 2 (H2)-receptor antagonist. Older clients are especially susceptible to central nervous system side effects of cimetidine. The most frequent of these is confusion. Less common central nervous system side effects include headache, dizziness, drowsiness, and hallucinations. 39.) The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse schedules the medication for which times?
  9. With meals and at bedtime
  10. Every 6 hours around the clock
  11. One hour after meals and at bedtime
  12. One hour before meals and at bedtime - CORRECT ANSWERS-4. One hour before meals and at bedtime Rationale: Sucralfate is a gastric protectant. The medication should be scheduled for administration 1 hour before meals and at bedtime. The medication is timed to allow it to form a protective coating over the ulcer before food intake stimulates gastric acid production and mechanical irritation. The other options are incorrect. 40.) The client who chronically uses nonsteroidal anti-inflammatory drugs has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted?
  13. Resolved diarrhea
  14. Relief of epigastric pain
  15. Decreased platelet count
  16. Decreased white blood cell count - CORRECT ANSWERS-2. Relief of epigastric pain Rationale:

erosive esophagitis, and pathological hypersecretory conditions. The other medications listed are proton pump inhibitors. H2-receptor antagonists medication names end with -dine. Proton pump inhibitors medication names end with -zole. 44.) A client is receiving acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer. The nurse should have which item available for possible use after giving this medication?

  1. Ambu bag
  2. Intubation tray
  3. Nasogastric tube
  4. Suction equipment - CORRECT ANSWERS-4. Suction equipment Rationale: Acetylcysteine can be given orally or by nasogastric tube to treat acetaminophen overdose, or it may be given by inhalation for use as a mucolytic. The nurse administering this medication as a mucolytic should have suction equipment available in case the client cannot manage to clear the increased volume of liquefied secretions. 45.) A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:
  5. Watch for irritability as a side effect.
  6. Take the tablet with a full glass of water.
  7. Take an extra dose if the cough is accompanied by fever.
  8. Crush the sustained-release tablet if immediate relief is needed. - CORRECT ANSWERS-2. Take the tablet with a full glass of water. Rationale: Guaifenesin is an expectorant. It should be taken with a full glass of water to decrease viscosity of secretions. Sustained-release preparations should not be broken open, crushed, or chewed. The medication may occasionally cause dizziness, headache, or drowsiness as side effects. The client should contact the health care provider if the cough lasts longer than 1 week or is accompanied by fever, rash, sore throat, or persistent headache. 46.) A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse checks the client for:
  9. Pupillary changes
  10. Scattered lung wheezes
  11. Sudden increase in pain
  12. Sudden episodes of diarrhea - CORRECT ANSWERS-3. Sudden increase in pain Rationale: Naloxone hydrochloride is an antidote to opioids and may also be given to the postoperative client to treat respiratory depression. When given to the postoperative client for respiratory depression, it may also reverse the effects of analgesics. Therefore, the nurse must check the client for a sudden increase in the level of pain experienced. Options 1, 2, and 4 are not associated with this medication.

47.) A client has been taking isoniazid (INH) for 2 months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing:

  1. Hypercalcemia
  2. Peripheral neuritis
  3. Small blood vessel spasm
  4. Impaired peripheral circulation - CORRECT ANSWERS-2. Peripheral neuritis Rationale: A common side effect of the TB drug INH is peripheral neuritis. This is manifested by numbness, tingling, and paresthesias in the extremities. This side effect can be minimized by pyridoxine (vitamin B6) intake. Options 1, 3, and 4 are incorrect. 48.) A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:
  5. Drink alcohol in small amounts only.
  6. Report yellow eyes or skin immediately.
  7. Increase intake of Swiss or aged cheeses.
  8. Avoid vitamin supplements during therapy. - CORRECT ANSWERS-2. Report yellow eyes or skin immediately. Rationale: INH is hepatotoxic, and therefore the client is taught to report signs and symptoms of hepatitis immediately (which include yellow skin and sclera). For the same reason, alcohol should be avoided during therapy. The client should avoid intake of Swiss cheese, fish such as tuna, and foods containing tyramine because they may cause a reaction characterized by redness and itching of the skin, flushing, sweating, tachycardia, headache, or lightheadedness. The client can avoid developing peripheral neuritis by increasing the intake of pyridoxine (vitamin B6) during the course of INH therapy for TB. 49.) A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:
  9. Should always be taken with food or antacids
  10. Should be double-dosed if one dose is forgotten
  11. Causes orange discoloration of sweat, tears, urine, and feces
  12. May be discontinued independently if symptoms are gone in 3 months - CORRECT ANSWERS-3. Causes orange discoloration of sweat, tears, urine, and feces Rationale: Rifampin should be taken exactly as directed as part of TB therapy. Doses should not be doubled or skipped. The client should not stop therapy until directed to do so by a health care provider. The medication should be administered on an empty stomach unless it causes gastrointestinal upset, and then it may be taken with food. Antacids, if prescribed, should be taken at least 1 hour before the medication. Rifampin causes orange-red discoloration of body secretions and will permanently stain soft contact lenses. 50.) A nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report:
  13. Impaired sense of hearing
  1. Tingling and numbness of the fingers - CORRECT ANSWERS-1. Signs of hepatitis
  2. Flu-like syndrome
  3. Low neutrophil count
  4. Ocular pain or blurred vision Rationale: Rifabutin (Mycobutin) may be prescribed for a client with active MAC disease and tuberculosis. It inhibits mycobacterial DNA-dependent RNA polymerase and suppresses protein synthesis. Side effects include rash, gastrointestinal disturbances, neutropenia (low neutrophil count), red-orange body secretions, uveitis (blurred vision and eye pain), myositis, arthralgia, hepatitis, chest pain with dyspnea, and flu-like syndrome. Vitamin B6 deficiency and numbness and tingling in the extremities are associated with the use of isoniazid (INH). Ethambutol (Myambutol) also causes peripheral neuritis. 54.) A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?
  5. "I will take my pills every day at the same time."
  6. "I will be certain to avoid alcohol consumption."
  7. "I have already called my family to pick up a Medic-Alert bracelet."
  8. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated." - CORRECT ANSWERS-4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated." Rationale: Ecotrin is an aspirin-containing product and should be avoided. Alcohol consumption should be avoided by a client taking warfarin sodium. Taking prescribed medication at the same time each day increases client compliance. The Medic-Alert bracelet provides health care personnel emergency information. 55.) A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3. mEq/L and is complaining of anorexia. A health care provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?
  9. 3 to 5 ng/mL
  10. 0.5 to 2 ng/mL
  11. 1.2 to 2.8 ng/mL
  12. 3.5 to 5.5 ng/mL - CORRECT ANSWERS-2.) 0.5 to 2 ng/mL Rationale: Therapeutic levels for digoxin range from 0.5 to 2 ng/mL. Therefore, options 1, 3, and 4 are incorrect. 56.) Heparin sodium is prescribed for the client. The nurse expects that the health care provider will prescribe which of the following to monitor for a therapeutic effect of the medication?
  13. Hematocrit level
  14. Hemoglobin level
  15. Prothrombin time (PT)
  16. Activated partial thromboplastin time (aPTT) - CORRECT ANSWERS-4. Activated partial thromboplastin time (aPTT) Rationale:

The PT will assess for the therapeutic effect of warfarin sodium (Coumadin) and the aPTT will assess the therapeutic effect of heparin sodium. Heparin sodium doses are determined based on these laboratory results. The hemoglobin and hematocrit values assess red blood cell concentrations. 57.) A nurse is monitoring a client who is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?

  1. The development of complaints of insomnia
  2. The development of audible expiratory wheezes
  3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/ mm Hg after two doses of the medication
  4. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication - CORRECT ANSWERS-2. The development of audible expiratory wheezes Rationale: Audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm. β- Blockers may induce this reaction, particularly in clients with chronic obstructive pulmonary disease or asthma. Normal decreases in blood pressure and heart rate are expected. Insomnia is a frequent mild side effect and should be monitored. 58.) Isosorbide mononitrate (Imdur) is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. The nurse appropriately suggests that the client:
  5. Cut the dose in half.
  6. Discontinue the medication.
  7. Take the medication with food.
  8. Contact the health care provider (HCP). - CORRECT ANSWERS-3. Take the medication with food. Rationale: Isosorbide mononitrate is an antianginal medication. Headache is a frequent side effect of isosorbide mononitrate and usually disappears during continued therapy. If a headache occurs during therapy, the client should be instructed to take the medication with food or meals. It is not necessary to contact the HCP unless the headaches persist with therapy. It is not appropriate to instruct the client to discontinue therapy or adjust the dosages. 59.) A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?
  9. Monitor for renal failure.
  10. Monitor psychosocial status.
  11. Monitor for signs of bleeding.
  12. Have heparin sodium available. - CORRECT ANSWERS-3. Monitor for signs of bleeding. Rationale: Tissue plasminogen activator is a thrombolytic. Hemorrhage is a complication of any type of thrombolytic medication. The client is monitored for bleeding. Monitoring for renal failure and monitoring the client's psychosocial status are important but are not the